Outcomes of Stapled Transanal Rectal Resection vs . Biofeedback for the Treatment of Outlet Obstruction Associated with Rectal Intussusception and Rectocele: A Multicenter, Randomized, Controlled Trial
| Autor: | Paul A, Lehur, Angelo, Stuto, Michel, Fantoli, Roberto D, Villani, Michel, Queralto, Franck, Lazorthes, Michael, Hershman, Alfonso, Carriero, François, Pigot, Guillaume, Meurette, Prashanthi, Narisetty, Prashanty, Narisetty, Richard, Villet |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Anal Canal Rectum Biofeedback behavioral disciplines and activities law.invention Cohort Studies Patient satisfaction Randomized controlled trial law Surgical Stapling medicine Humans Aged Stapled transanal rectal resection Aged 80 and over business.industry General surgery Rectocele Gastroenterology Biofeedback Psychology Recovery of Function General Medicine Middle Aged Colorectal surgery Surgery Europe Treatment Outcome medicine.anatomical_structure Patient Satisfaction Quality of Life Female Obstructed defecation medicine.symptom business Intussusception Cohort study |
| Zdroj: | Diseases of the Colon & Rectum. 51:1611-1618 |
| ISSN: | 0012-3706 |
| Popis: | This study was designed to assess the safety and outcomes achieved with stapled transanal rectal resection vs. biofeedback training in obstructed defecation patients.A total of 119 women patients who suffered from obstructed defecation with associated rectocele and rectal intussusception were randomized to stapled transanal rectal resection or biofeedback training. Stapled transanal rectal resection was performed by using two circular staplers to produce transanal full-thickness rectal resection. Primary outcome was symptoms of obstructed defecation resolution at 12 months; secondary outcomes included safety, change in quality of life score, and anatomic correction of rectocele and rectal intussusception.Fourteen percent (8/59) stapled transanal rectal resection and 50 percent (30/60) biofeedback training patients withdrew early. Eight (15 percent) patients treated with stapled transanal rectal resection and 1 (2 percent) biofeedback patient experienced adverse events. One serious adverse event (bleeding) occurred after stapled transanal rectal resection. Scores of obstructed defecation improved significantly in both groups as did quality of life (both P0.0001). Successful treatment was observed in 44 (81.5 percent) stapled transanal rectal resection vs. 13 (33.3 percent) evaluable biofeedback training patients (P0.0001). Functional benefit was observed early and remained stable during the study.In this controlled trial, stapled transanal rectal resection was well tolerated, was more effective than biofeedback training for the resolution of obstructed defecation symptoms, and improved quality of life, with minimal risk of impaired continence. Thus, stapled transanal rectal resection offers a new treatment alternative for obstructed defecation after failure of conservative measures including biofeedback training, a noninvasive approach. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink